Confronting the death of a parent, spouse, or friend is overwhelming. We may struggle with questions such as what will holidays be like without him? How will you go on without her? You know you’re not ready to let go, but it’s important that your loved one is comfortable at the end — even if that means accepting outside help from others. Hospice services may be the help that you need.

Why hospice?

Hospice services can be the help that is needed in your loved one’s final precious days so that you can both make the most of the time that is left. Hospice is a philosophy of care recognizing death as the final stage of life.

Professional hospice staff ensure that the patient’s wishes are being listened to and carried out. They also provide the physical, spiritual, and emotional support that you may not yet even know that you or your loved one might need.

Hospice is a comprehensive program of comfort, or palliative care, based on the belief that every day has meaning and providing freedom of pain, fear and uncertainty enhances the quality of life for those facing the end of life.

When should you consider hospice?

Hospice care may be an appropriate choice when a client can no longer benefit from curative treatments and has a limited life expectancy, as diagnosed by a physician.

Hospice service begins when the client, physician and family decide it is best.

If the client or family member’s situation changes, the client’s condition improves or the disease goes into remission the client can be discharged from hospice services, yet resume services at a later date if needed.

Do my loved one’s benefits cover hospice care?

The cost of hospice care is covered for a variety of ages. Most private insurance plans offer hospice coverage and follow the Medicare guidelines.

The benefit helps to cover services and care provided by the hospice team, medications and equipment related to the hospice diagnosis, and/or a variety of care levels, including routine, respite, general inpatient and continuous care (as appropriate).

If you are interested in hospice care, contact your loved one’s doctor, or your loved one’s facility’s social services department. These professionals will help you get started down the road to hospice services that may be able to serve you in your life’s most difficult situation.

Seniors commonly talk about the end of life. Your family member may speak of dying or longing to go to heaven. This doesn’t have to be cause for alarm. It’s important to recognize the difference between sadness, reflection on one’s life, and thoughts of suicide.

If you see a loved one exhibiting serious signs like prolonged depression, anxiety, or talking about harming themselves, they may be at risk. If you believe a loved one is suicidal, you must take action.

1. Call 911 if it’s an immediate emergency.

Get help from professionals who specialize in crisis intervention and suicide prevention. See below for crisis hotlines, and the sources at the bottom of this article for additional resources.

2. Do not leave the person alone.

Take away access to firearms, medications, sharp objects, belts, cords, cars, plastic bags and other means that could be used to attempt suicide.

3. Do not be sworn to secrecy. Reach out to family members, friends or clergy who may be able to help talk to the person.

4. Be direct. It is a myth that talking about suicide will lead a person to be suicidal. Talk openly and matter-of-factly about the person’s feelings and intentions.

5. Do not be argumentative or judgmental. This may make the person feel defensive and less willing to accept help.

As children, we looked to our parents to meet nearly every need. Our parents instinctively provided love, support and guidance as they raised us to become independent adults. Now, as our parents age, there may come a time when we adult children evolve into the role of a “parent” to our parents. Parenting a parent presents unique challenges, so here are a few tips to help navigate this new role:

1. Understand your parent’s specific needs

Do they need help with medication management? Do they need guidance with their budget? Do they require hands-on assistance with activities of daily living such as brushing their teeth, taking a bath, or making dinner? Understanding their specific needs helps adult children to act in a supportive role, while still maintaining their dignity.

2. Customize a Plan to Help Your Parent

Each senior has a unique situation. Your parent may only need help managing their finances, and this is all of the guidance and support that they need. As much as possible, allow them to maintain a sense of control, while still getting necessary help.

3. Acknowledge Their Need for Independence

Parenting a parent is an ongoing challenge and the key to a successful transition from adult child to senior caregiver is to preserve and protect your parent’s dignity. Try to refrain from using a condescending tone or treating them in a childlike manner. Instead, ask for their input in decisions, while still providing them guidance as needed. This will make the role reversal easier for the both of you.

4. Practice Gentle Assertiveness

Remember, this is your parent and now you are assuming the role of their parent. When addressing difficult topics, be respectful but assertive. It will take time for both of you to adjust to the shift in the dynamic. This is most important when dealing with safety concerns, such as driving or living alone.

5. Focus on the positive

It is easy to get lost in the duties of your new role, but always remember to enjoy the time you have with your loved one.Over time, relationships and roles evolve. Be patient with yourself and your parent as you embrace this new dynamic. Never forget all of the valuable life lessons that your parents shared with you, therefore make it your goal to parent them in a similar way.

Each of us struggle at times to make conversation with others, whether they are family members, co-workers, or strangers. Most of us rely on default topics such as politics, the weather, or jobs. Instead, try one of these thoughtful questions to that will help you begin funny, beautiful, or heartfelt conversations:

What book would you recommend to your friends?

What are your top 5 favorite movies of all time?

If you could only eat one thing for the rest of your life, what would it be?

What song or singer do you love to listen to?

If money and/or time were no object, what would you want to do? Where would you go? Who would be there? How would you fill your days?

What do you think the best age to be is? Why?

When did you know that your spouse was “the one”?

How did you choose your children’s (or pets’) names?

What’s the best advice your parents gave you? Did you listen to it?

Who do you admire most? Why?

Who is someone who inspires you? How so?

At what moment in your life do you remember laughing the hardest?

What’s something in your life that you are really good at? What’s something that you wish you were really good at?

What’s something you did that was embarrassing at the time, but you now see the humor in?

What was your favorite thing to do as a kid? (What did you save your allowance for? What did you race home after school to do? What did you write, talk, and dream about?)

What moment in history do you most vividly remember? (Where were you? What were you doing? How were you affected?)

What are you the most proud of in your life?

What is the hardest lesson you have ever learned?

What did you learn in your career that you wish you have known earlier?

What’s your number one piece of life advice?

What do you hope people remember about you?

Genuinely listening to someone is an act of kindness. Ask someone to share their story with you, and the conversation will be a gift to you both.

Unsure if you need to outline your healthcare preferences and end-of-life wishes? The answer is yes, you do. Too often, we wait for a crisis to discuss how we want our medical care to be directed. During these stressful times, there are many decisions that have to be made very quickly. You can ease the stress, and make sure your wishes are known, by creating an advance directive.

An advance directive is a legal document that provides written instructions for the care of your health and finances in the event that you become temporarily or permanently incapable of making or communicating these decisions.

You need an advance directive even if you are you still young. You could have a healthcare crisis or accident at any time, and your family may not know your wishes. If you have children at home, advanced care planning isn’t just about covering medical decisions, it can help outline the safety nets you want in place for other people to take care of them. It’s important to discuss these things with your parents, spouse and children. Your views on what you want may differ from theirs, and it’s crucial that they know how you want your care carried out.

An advance directive is different than a will. Your will only allocates where you want your resources and possessions to go. Your advance directive covers the healthcare decisions you want made. Even if you are pretty sure that your family know what you would want in an emergency situation, they may struggle to make a decision in the moment. They may want to do everything they can to save you, but if you don’t want those extreme measures taken, you need to let them know and have it officially documented in your advance directive. Also, if you know there’s going to be discrepancies between family regarding things like organ donation, DNR orders, or extreme life-sustaining measures, the need to have legal documentation outlining your wishes also helps point to who your healthcare advocate should be.

Many report the belief that discussing end-of-life wishes with their family will upset them. However, open and honest dialogue will help ensure your family knows exactly what you want. Your wishes may be different from another family member’s, and that’s OK. As long as you understand each other, and know where official documentation is filed, both you and your family can have peace of mind knowing decisions about your life and your care will be what you want.

You and your family may go through some anticipatory grief talking about these issues as nobody wants to think about their loved ones dying. However, making these decisions now can help relieve some of your family’s uncertainty, stress and grief in the midst of tragedy. Talk to your local long-term care facility, your county social worker, or an attorney to help get started on the process. It only takes a few minutes of advance preparation to avoid many stressful situations in the future.

For too many seniors in our country, abuse or neglect is an all-too-real part of life. Knowing the signs of elder abuse, as well as where to get help, can change that. It is important to know the definition of elder abuse. Elder abuse can be:

Physical: such as hitting or restraining a person

Sexual: including any non-consensual contact

Emotional: such as humiliating, intimidating, threatening or repeatedly ignoring a person

Neglect or abandonment: including preventing a person from receiving basic needs

Exploitation: theft of a person’s money, property or assets

Know the WARNING SIGNS OF ABUSE:

Unexplained injuries, such as scratches, bruises or welts

Withdrawal from usual activities and relationships

Sudden changes in habits such as spending, hygiene or appearance

Changes in mood(or mood swings) such as depression, confusion, insomnia, anger or crying

Any mention of mistreatment

Keep in mind that these signs may not be caused by elder abuse, but do follow up to root out the causes.

If you suspect abuse, always dial 911 for immediate help. If someone isn’t in immediate danger but you suspect abuse, talk to the dispatcher about the situation and what you can do.

Remember, some seniors may feel ashamed or afraid to report abuse. You might have to step in to seek help.

Where to find more help:

National Domestic Violence Hotline. This hotline is available 24/7 to offer resources and support. Call 1-800-799-7233.